Bacterial vaginosis - a state of the microflora of the vagina, in which the number of useful lactobacilli decreases significantly, and the pathogenic - increases. It can develop for many reasons - from the presence of sexual infection to a banal decrease in immunity. Symptoms of bacterial vaginosis are manifold and not always pronounced brightly. But regular check-ups at the gynecologist will allow not to miss an ailment, and to appoint therapy in time. Who is at risk? And how to treat bacterial vaginosis most effectively?
Reasons for the emergence of
Nature has provided various mechanismsa woman's body to protect against the development of pathologies, including infections. But modern fashion trends in genital hygiene, a variety of sexual contacts, etc.- all this often violates the normal biocenosis of the mucosa, promoting the development of bacterial vaginosis.
Normal flora
In the vagina on the "guard of order" are sticks of Dederlein, which are so named after the pioneer. The number of them should normally exceed 1 * 108 CFU / ml when sowing the contents with mucous membranes, and should reach 95 - 98% of the total number of microorganisms. These lactobacilli perform a number of functions, imperceptibly protecting the woman's body from the development of a conditional and pathogenic flora that can be present in the vagina permanently or temporarily. Their main action:
- Dederlein's sticks produce lactic acid in the process of their vital activity, which creates an acidic environment in the vagina. Under such conditions, many bacteria causing diseases die right away. And the sticks of Dederlein with an acidic pH multiply unhindered.
- Also lactobacilli produce lysozyme - a substance that "dissolves" pathogenic microorganisms.
- Acid medium conducts "selection" among spermatozoa, leaving only healthy forms for fertilization of the egg.
The role of the Dederlein sticks is invaluable. But the number of them can be significantly varied, which depends on many factors.
Stages of development of bacterial vaginosis
Under certain conditions, the number of useful lactobacilli decreases. In this case, they are beginning to actively replace pathogenic microorganisms, which either entered the vagina, or were always present here, but in minimal values.
Similar bacteria create an alkaline environment, which prevents the proliferation of Dederlein sticks and further exacerbates the situation. In this case, the epithelium of the vaginal mucosa begins to slough actively due to the impact of pathogens on it. As a result, leucorrhoea appears, which exceed the usual values.
As a result, the main composition of the vaginal microflora is not lactobacilli, but others: peptococci, gardnerelles, bacteroides, leptotrichs, mycoplasmas, ureaplasma and others. Among them there may appear unambiguous pathogens that enter the vagina with unprotected sexual intercourse - chlamydia, trichomonads, gonococci, as well as herpes or papilloma viruses.
Effective treatment of bacterial vaginosis involves the elimination of all pathogenic microorganisms and the creation of conditions for the active multiplication of the Dederlein sticks.
Risk Factors for
Bacterial vaginosis is not an inflammatory pathology, but it can occur against the background of an existing sexual infection. Often this condition is called gardnerellez, as these bacteria predominate in most cases.
Bacterial vaginosis develops under the influence of the following factors:
- Violation of the balance of sex hormones( with the predominance of progesterone), the work of the thyroid( more often with hypothyroidism).Also with an increase in androgens.
- With the development of systemic autoimmune diseases and prolonged use of cytostatic and hormonal drugs.
- When the intestinal microflora is disturbed, the qualitative and quantitative composition of the vaginal microorganisms also changes.
- Often develops during menopause on the background of atrophic changes in the mucosa.
- With prolonged courses of antibiotic therapy for a disease.
- If the rules of personal hygiene are not respected. For example, many believe that douching is useful. But prolonged washing of the vagina can, on the contrary, bring harm.
- Also the use of certain spermicides( in particular, containing nonoxynol), contributes to the violation of the flora.
- Frequent change of sexual partners and lack of protection from infections.
It is possible to identify women who are at risk for developing bacterial vaginosis. These include:
- Those who have acute( disease-related) or chronic immunodeficiency conditions.
- Women of "easy" behavior and with promiscuous sexual intercourse.
- Overweight. Here there is a violation of hormonal balance in the body.
- Those who regularly practice oral, anal and other types of sex.
- Women with thyroid pathology, diabetes mellitus, or other metabolic disorders.
Symptoms of pathology
Clinical manifestations of bacterial vaginosis can appear even in girls who do not yet have a sexual life. In such situations, it is due to some kind of disturbances in the body. The symptoms of gardnerellez can develop independently of sexual intercourse. But if it is provoked by him, then the first signs appear only after 24 - 48 hours. These include:
- Increase in the amount of whites. They acquire a gray shade. Most often noticeable immediately after the menstrual period. Beli have a characteristic "fishy" smell.
- Also sometimes there is itching and burning, redness in the genital area and vagina.
Sometimes symptoms are subtle or come-they are found several times a month. In such cases, you can not give them due attention. Is it necessary to treat bacterial vaginosis? Of course, it is necessary, otherwise the reduction of local protective forces will lead to various inflammatory diseases. And the process can already move to the uterine cavity, appendages and cause irreversible disturbances.
Diagnosis
The woman herself, of course, can assume she has bacterial vaginosis. But only a specialist can confirm the fact and prescribe an effective treatment.
When diagnosing a complaint, complaints may not always be present, but their presence is given special attention. A careful survey may suggest some kind of chronic pathology, for example, diabetes mellitus or problems with the thyroid gland.
Inspection provides a detailed picture of the presence of the disease. In this case, the doctor pays attention to gray leucorrhoea, the number of which is higher than normal. Even without a special examination, sometimes there is an unpleasant "fishy" smell. And when you add to the contents of the vagina on the gynecological tool a solution of potassium hydroxide, it repeatedly amplifies and resembles a already rotten aroma - this is an aminotest. Thus the environment of the contents of the vagina will always be alkaline.
Taking a normal swab from the vagina to the flora confirms the assumption. With microscopy, "key cells" and a reduction in the number of Dederlein sticks are found. Pathogenic flora may appear, for example, Trichomonas, etc. Key cells are accumulations of leukocytes, elements of the vaginal epithelium, and gardnerella are often attached.
Also, determining the qualitative and quantitative composition of the flora of the vagina, it is possible to identify the sensitivity of microorganisms to various drugs. Proceeding from this then the most effective preparations for the treatment of bacterial vaginosis will be selected.
Treatment of vaginosis
Therapy of bacterial vaginosis, as a rule, does not bring any particular difficulties if the course is not burdened by any sexual infections. Therefore, before the start of treatment, you should undergo a complete PCR and culture culture on STI.
Therapy consists of several stages. The appointment of certain drugs in a particular situation can only be determined by a doctor.
Antibacterial drugs or drugs with a similar effect
The standard of treatment is metronidazole. It can be a pill with it, a candle from bacterial vaginosis or even a gel. The standard scheme: tablets of 500 mg to 1 twice a day for 7 to 10 days. Metronidazole is also a part of Metrogil, Flagil and others.
Less commonly used is clindamycin. It can be given in tablets, candles or as a gel. Often the treatment regimen includes several forms of the drug. For example, tablets and candles at the same time.
Instead of antibiotics, iodine-containing and other antiseptic medications in the form of suppositories can be used. Often they are used because of their safety in pregnant women. These are preparations "Betadin", "Povidone-iodine", "Geksikon", "Chlorhexidine" and others.
Popular inclusion in the scheme of candles with a combined action - antibacterial, antiprotozoal, anti-inflammatory and others. For example, "Terzhinan" or "Polizhinaks."
Preparations for the restoration of the flora of the vagina
Along with the main treatment, the therapy is administered, in parallel or after the course, to restore the number of Dederlein sticks. This is a guarantee that the relapse will not occur in the near future. Any preparations can be used, for example, "Laktozhinal", "Bioflora", "Vaginorm" and others. Duration and dose is determined by the doctor.
Means to strengthen the immunity
The treatment complex often includes suppositories or pills to strengthen local immunity. Most often these are different types of interferons - "Viferon", "Ruferon" and the like.
Other
agents If necessary, antifungal agents are included in the scheme( for symptoms of thrush).
In the detection of a specific infection( gonorrhea, trichomoniasis, chlamydia and others), treatment includes etiotropic drugs. Most often it is an additional antibiotic or an antiviral agent.
We recommend reading an article about gonorrhea. From it you will learn about the ways of infection and the signs of the presence of the disease, the symptoms of the lesion, the diagnosis, the treatment of the infection and possible relapses.
Prevention
Like any disease, bacterial vaginosis is easier to prevent. Recommendations are of the following nature:
- regular examination of a gynecologist and timely treatment of diseases;
- use of barrier methods of contraception, wearing of linen only from natural fabrics;
- strengthening of immunity in natural ways: exercise, hardening, etc.;
- treatment of chronic pathologies of internal organs;
- avoiding douching and other similar procedures.
Bacterial vaginosis is a pathology that reflects a decrease in the level of body protection at the moment. Often leaking malosimptomno, gardnerellez always found when examining a gynecologist. Only a doctor can prescribe the most effective tablets against bacterial vaginosis, candles or other forms. Do not delay with treatment!